Changes in the brain can cause a person with dementia to become confused and disoriented, even when in a familiar place. They may not be able to find their way back home, and become lost.
Wandering is a common behaviour associated with Alzheimer's disease and other dementias, often leading to stress as well as safety concerns. Although wandering is more common in the middle or later stages of dementia, it can occur at any point during the disease. Whether or not the person you are caring for wanders, it is a good idea to take proactive steps to understand this particular behaviour and reduce their risk.
Reasons for Wandering
Every individual with dementia is unique. However, there are some common reasons why people with dementia may be at risk of wandering.
The person may be too hot or too cold in their current location.
The person may be agitated due to medication, too much noise, or other forms of over-stimulation.
They may be hungry or in pain.
The person may believe they need to leave the house in order to go to work, or take care of their children.
They may not recognize their own home, and may want to go somewhere that is more familiar.
They may be experiencing delusions and hallucinations due to their illness or medications.
They may be seeking relief from boredom.
They may have extra energy they need to use up.
New environments may increase disorientation (for example, moving to a new neighbourhood or a care home may increase someone's wandering risk)
The person may be continuing a long-standing habit (for example, perhaps the person has always enjoyed long walks)
Reducing the Risk of Wandering
It is imporatant to find solutions that honour the person's independence and freedom. The precautions you take will depend on what is appropriate for the individual you are caring for, as well as the features of the person's physical environment. For example, what will work for someone who lives in a small town may not be suitable for someone in a large urban centre.
Review the person's medications with their doctor. It may be possible to switch to drugs which are less likely to cause confusion or delusions.
Keep a diary of when and where the person tends to wander. Look for a pattern - this may give you clues as to what is triggering the behaviour.
Relocate locks on doors (for example, install above eye level or near the ground where the person may not look).
Try camouflaging doors with posters, wall hangings, or mirrors.
Consider purchasing alarms which will alert you when a door or window has been opened.
Consider purchasing door mats that set off an alarm when stepped on.
If night wandering is a problem, make sure the person has restricted fluids in the evening and has gone to the bathroom before bed.
Tell neighbours, nearby businesses, and your local police or RCMP detachment about the situation. They may be able to recognize if your family member appears disoriented and be able to help.
Prescription medications may be appropriate for some individuals who wander. Speak to their doctor about the options.
Encourage the person to engage in regular physical activity. This can reduce agitation and use up any extra energy.
Provide a safe area for pacing, such as an outdoor garden.
Wanting to Go Home
It's very common for people with dementia to become fixated on wanting to "go home" - even when they are home. This can be very stressful, both for the person and for the caregiver. Fortunately, this is a phase that will pass as the illness progresses, but in the meantime, caregivers will need to find coping strategies that are both creative and tactful.
The reason for wanting to going home varies from person to person. Understanding the root reason for people wanting to go home can help you to manage this behaviour.
Possible Reasons for Wanting to Go Home
Unable to recognize current home.
A recent move to an unfamiliar place.
Wanting to go to childhood home or wanting to see a loved one from the past.
“Home” can mean a time when life was more comfortable.
Try to determine the emotion being expressed (anxiety, fear, insecurity) and respond to that ("I'll take care of you" or "Are you feeling lonely?").
Try to determine why the person expresses the need to go home.
Remove objects that might be reminding the person to go home (coats, hats, purse).
Distract or redirect the person’s attention to a different activity (such as looking at photos and reminiscing together or going for a walk).
Try not to contradict the person’s wish to go home, instead reassure the person.
Give the person a reason to stay longer (for example, offer them their favourite dessert).
When a Wandering Incident Occurs
Quickly search the vicinity of where the person was last seen.
Check for car keys, luggage, or other items that may indicate where the person may have gone.
Notify the police of any locations that the person may wander to, such as a former workplace, previous address, or favourite shop.
Alert friends and neighbours to the situation.
Have someone stay at home in case the person returns.
After an emergency situation, some caregivers choose to re-evaluate the person with dementia's living situation. The Alzheimer Society of B.C. is here to help with these decisions.
It is important to remember that no one thing is going to ensure the safety of a person with dementia. Multiple strategies are recommended.
The Alzheimer Society of B.C. can assist people with dementia and their families to explore a variety of practical strategies to minimize the risk of wandering and to be prepared if wandering does occur. Contact your local Alzheimer Resource Centre.